A year after it began, the COVID-19 pandemic is not yet over. In the meantime, there have been many medical and scientific discoveries that allow us to manage the infection better and, above all, to contain its spread.
How is the SARS-CoV-2 virus transmitted? As data and evidence have built up over the course of the pandemic, scientific understanding of the virus has changed. All studies and outbreak investigations to date indicate that most transmission occurs through direct contact with infected people, who release droplets of contaminated saliva into the air when they talk, breathe and cough, some of them very small (known as droplets).
The main route of transmission is therefore the air. In enclosed spaces, especially where contaminated aerosol is present (for example the aerosol produced in a medical or dental setting in the presence of a super-spreader, who may be asymptomatic), that air can remain infectious for a prolonged period.
By contrast, the risk of indirect infection, that is, through contact with a contaminated surface or object (a fomite), is much lower, as explained by Emanuel Goldman, a microbiologist at Rutgers New Jersey Medical School, in an article published in July 2020 in The Lancet Infectious Diseases. Since then, many other researchers have reached the same conclusions, so much so that the US Centers for Disease Control and Prevention changed their anti-COVID guidelines.
This evidence shows how important it is to pay close attention to distancing and to spreading out patient flows within medical and dental practices, so that people do not gather in waiting rooms or other shared spaces. Ventilation is equally important: it can be natural (opening windows and doors) or mechanical, and ideally guided by CO2 (carbon dioxide) detectors. For optimal indoor air quality, the CO2 level should be the same as in the open air, and never above 1,500 ppm.
Another very important aspect is keeping the air clean, using multiple high-speed suction systems, possibly with the addition of HEPA filters. Although HEPA filters are not included in the recommendations of the CTS (Italy’s Technical and Scientific Committee) for dentistry, they have become widespread in dental practices, which shows how seriously dentists take this issue.
As for indirect contamination, given the very high level of disinfection of objects and surfaces normally seen in a medical or dental practice, the risk is almost non-existent. Add normal precautions such as washing your hands frequently and not touching your face, and the risk is close to zero.
The measures adopted by dental practices have therefore worked, and continue to work extremely well. This is shown by the fact that, to date, no clusters have been identified in any dental facility, and no COVID-19 illness has been reported to INPS (Italy’s national social security institute) by professionals in our sector.
As a further guarantee of safety for patients and professionals, the vast majority of dental practices, like other healthcare facilities in the Emilia-Romagna region, are now protected by vaccination. We can therefore confidently say that dental practices today are, as we had hoped here at COBE Dental, COVID-free.
Bibliography:
Dyani Lewis, COVID-19 rarely spreads through surfaces. So why are we still deep cleaning?, Nature, 29 January 2021.
Goldman Emanuel, Exaggerated risk of transmission of Covid-19 by fomites, Lancet Infection Diseases, July 2020.
Mondelli M.U., Coloneri M., Seminari E. M., Baldanti F., Bruno R., Low risk of SARS-Cov-2 transmission by fomites in real-life conditions, Lancet Infection Diseases, September 2020.
Schöps Corinna, Una ventata d’aria contro il Covid-19, Die Zeit, Germany, October 2020.
Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC., Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review, JAMA, 25 August 2020.
Credits: Photo by Attentie Attentie on Unsplash
